Bereavement, grief, loss

Why am I putting this here when it’s obviously either too simple to need expansion or too huge to condense here.

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Well of course bereavement is loss of another person (or sometimes a pet) by death of that other and loss is loss and so much wider but a key part of bereavement and grief is a very complex set of emotions, cognitions and behaviours linked with loss and particularly with bereavements. Perhaps I am writing about it because my mother died in September and I had another loss. See a more personal and immediate take on that here in my personal web site: PSYCTC.org. To really cap off a tough autumn I have since taken a bit of a battering with my own health: more loss. Certainly these topics are in my mind.

However, I have been thinking about them pretty much since I started the clinical phase of my medical training back in 1978 and I worked alongside a “terminal care support team” for most of a year back in 1983 so this is not all new to me. More recently I have had enormous pleasure and satisfaction working with Pablo Sabucedo around these issues (see publications in my CV if you want to pursue that work, particularly looking at SED: Sensory and quasi-sensory Experiences of the Deceased: search for “Sabucedo” in my publication list in my CV).

But why am I risking an entry? Because I think this is an interesting and important example of where psychiatrists, psychologists and psychotherapists often find themselves in a grey area about whether something so painful, perhaps so crippling of everyday function needs a label for it to merit help. It’s an interesting example as it has a clear immediate precipitant: we seem to have causality; depending on your culture and a number of other things there is also some degree of similarity between the subjective emotions and their expression in the face and body, and in the thoughts and behaviours that are out of the pre-bereavement normal for that person.

However, a friend, a psychiatrist and psychiatrist gave me this recently:
“My thinking on grief, apart from subscribing to the idea that you move between three feelings – anger, sadness and guilt – rather than ‘stages’ and that the intensity of those feelings and rapidity of the oscillations diminish over time, is that it is wholly specific to the constellation of the family and the material circumstances.”
I liked that and it criticising the “stages of grief” idea is a theme for Pablo and myself.

However, that lovely summary also brought in the “constellation of the family” and “material circumstances”. Quite so. To me grief is both personal and relational and specific to the individual with grief and the person who has died and, except for already unusually isolated individuals it is also embedded in other family with their own relationships both the grieving person and the deceased. I am very leary of categorisations that locate something so relational in individuals. Of course we are always individual and relational: if one of a couple is to break a leg that is individual, it’s no good splinting or operating on the partner’s leg, however, even that fracture is not without its relational, and material side: how well will the couple handle the new situation? What financial and other resources will they have to make the recovery easier.

As well as this quintessentially relational nature of grief, including crippling extremes of grief, there are certainly material practicalities. Finally, I believe very strongly that while griefs are universally human, I also believe they are held in societal, cultural and, for many, spiritual narratives and matrices of connection. In the UK in the 21st Century the cultural frameworks are different from in the 19th Century even and way different from say the 16th and always cultures frame this partly in relation on material wealth and power.

Just a plea to hide from these complexities by doling out labels: use them carefully if you and the client will find them helpful but let’s watch that they don’t become traps.